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中华妇幼临床医学杂志(电子版) ›› 2010, Vol. 06 ›› Issue (06) : 421 -424. doi: 10.3877/cma.j.issn.1673-5250.2010.06.008

论著

卵巢幼年型粒层细胞瘤诊治研究
王奕, 徐畅, 刘文英, 黄晓然, 王威亚, 钟麟   
  1. 610041 四川成都,四川大学华西医院小儿外科
  • 出版日期:2010-12-01

Diagnosis and Therapy in Ovarian Juvenile Granulose Cell Tumor

Yi WANG, Chang XU, Wen-ying LIU, Xiao-ran HUANG, Wei-ya WANG, Lin ZHONG   

  1. Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
  • Published:2010-12-01
引用本文:

王奕, 徐畅, 刘文英, 黄晓然, 王威亚, 钟麟. 卵巢幼年型粒层细胞瘤诊治研究[J/OL]. 中华妇幼临床医学杂志(电子版), 2010, 06(06): 421-424.

Yi WANG, Chang XU, Wen-ying LIU, Xiao-ran HUANG, Wei-ya WANG, Lin ZHONG. Diagnosis and Therapy in Ovarian Juvenile Granulose Cell Tumor[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2010, 06(06): 421-424.

目的

探讨卵巢幼年型粒层细胞瘤(juvenile granulose cell tumor, JGCT)的临床及病理特点和治疗策略。

方法

采取回顾性分析法分析1996年1月至2009年12月本院收治的3例(均为女性,年龄为8个月~4岁)卵巢幼年型粒层细胞瘤患儿的临床病历资料,分析其诊治特点。

结果

3例患儿均为右侧卵巢来源的粒层细胞瘤,临床症状以腹痛、腹胀、和腹部包块为首发。其中1例伴阴道流血及第二性征发育。对3例患儿均手术完整切除肿瘤,经病理学检查证实为幼年型粒层细胞瘤。术后,3例患儿均未行放、化疗,随访2~10年,未见肿瘤复发。

结论

并非所有卵巢幼年型粒层细胞瘤患儿均出现假性性早熟临床表现,部分患儿也可以腹痛、腹胀和腹部包块等为首发症状,若对其能早期、完整手术切除肿瘤,则可不必行放、化疗,且预后良好。

Objective

To analyze the feature in clinic and pathology of ovarian juvenile granulose cell tumor (JGCT).

Methods

From January 1996 to December 2009, the clinical data of 3 girls at the age from 8-month to 4-year-old with ovarian juvenile granulose cell tumor which were treated at the Department of Pediatric Surgery, West China Hospital of Sichuan University were studied retrospectively.

Results

All of 3 girls had ovarian juvenile granulose cell tumor which originated from right ovary. Abdominal pain, abdominal distention and abdominal mass were found as the first symptoms. Among them, 1 case associated with vaginal bleeding and development of secondary sexual characteristics. Complete excision of the masses was perfumed. The pathological examination revealed ovarian juvenile granulose cell tumor. These 3 cases had a good prognosis in the follow-up (2-10 years) without any adjuvant chemotherapy or radiotherapy.

Conclusion

Children with ovarian juvenile granulose cell tumor may not have pseudo-precocious puberty. Abdominal pain, abdominal distention, and abdominal mass could be the first manifestations. It is unnecessary for curing ovarian juvenile granulose cell tumor to be administered by adjuvant chemotherapy or radiotherapy if the tumor can be excised completely early.

图1 8个月龄患儿CT检查结果示:腹腔巨大占位性病变,为囊实混合性,占据大部分腹腔(12 cm×8 cm),边界清楚。
图2 8个月龄患儿肿瘤表面包膜完整,边界清楚,来源于右侧卵巢,上至肝下,下至盆底,前后紧贴腹前后壁,几乎占满了整个腹腔,与周围无明显粘连
图3 3岁患儿的肿瘤标本组织病理学检查结果示:HE染色见大滤泡结构,颗粒细胞围绕空泡状滤泡,胞核染色质增多,细胞核深染,可见细胞核分裂象
图4 4岁患儿的肿瘤标本免疫组织化学染色示,inhibin-α呈阳性
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